17 Dec Can Cataract Surgery Be Repeated?
The correct answer to the question, can cataract surgery be repeated depends on the deeper question being asked. As a general rule, cataract surgery doesn’t need to be repeated, but there are a series of adjustments that could be make to improve the outcome if needed.
When friends ask me if cataract surgery can be repeated they are often really asking, can cataracts come back or is there anything else that could be done to improve my vision like exchanging the intraocular lens.
Can Cataracts Come Back?
The good news is that cataracts can’t come back once they have been removed. A cataract forms when the natural lens inside your eye becomes cloudy with age or trauma. In cataract surgery, the cataract lens is removed and a lens replacement implant is placed. Once removed, the lens is gone for good. The cataract does not come back.
What if the Surgeon doesn’t Remove the entire Cataract?
It is rare that the surgeon wouldn’t remove the entire cataract at the initial surgery. However, this can happen if a piece of the lens becomes lodged behind the iris where the surgeon can’t see it. At some point, the fragment dislodges and floats into the front part of the eye where it can be discovered. If this happens, the surgeon would either vaporize the fragment with a laser or return to the operating room to vacuum out the retained fragment.
Another complication scenario occurs when a fragment falls backwards into the vitreous of the eye. Cataract surgeons are experts in the front of the eye while retina surgeons are experts in the back part of the eye. If the lens fragment falls to the back part of the eye, the cataract surgeon will stop the case and have you see a retinal specialist to have it removed on another day.
Can the Intraocular Implant be Exchanged?
If the intraocular implant (IOL) is not the ideal power or if it is not adequately centered it can usually be exchanged or repositioned.
There are risks involved in exchanging an intraocular lens. Alternatives to an intraocular lens exchange include, glasses, contact lenses, limbal relaxing incisions, and laser vision correction. Contemplating an IOL exchange or reposition would require a careful analysis of the risks benefits and alternatives.
I see patients referred by me by other physicians to have their intraocular lens exchanged. Some patients consider an IOL exchange as “having their cataract surgery repeated,” but is not as the cataract removal has already taken place and we are merely exchanging the intraocular lens.
Secondary Cataract Removal
There is a clear membrane that surrounds your natural lens. An opening is made in the front of that membrane to create a window for cataract removal. Once the cataract is gone, the clear membrane is like a clear sack with an opening in the front. The intraocular lens is placed through the small opening into the membrane sack. This holds the implant in place.
Sometimes the membrane turns cloudy over time, causing glare and blurry vision. These symptoms are similar to the original symptoms caused by the cataract so some call this a “secondary cataract,” but it is not a cataract. It is merely a cloudy membrane. Fortunately, this is easily solved with a laser in the clinic, called a YAG, to clear an opening in the membrane.
If you are not satisfied with your vision after lens removal surgery, it may be that you have problems with other parts of your eye, like your retina, cornea, or your optic nerve. If your lens has been removed, a good intraocular lens is in the correct position, and there is no clouding from the posterior membrane, then there is nothing about cataract surery to repeat. There may be things that could be done with those other problems,
The truest answer to the questions, can cataract surgery be repeated and can a cataract come back is, No, though there are many things that can be done after the cataract removal to improve vision, focus, or clarity.
If I can provide any further information about your eyes, please schedule a time to meet with me or leave a comment.